Oral cleaning instruments, oral suctioning instruments, and tracheal suctioning catheters are commonly used in health care patients with respiratory distress, critical illness, chronic illness, terminal illness, weakness, paralysis, or any patient requiring breathing support from a ventilator.
To perform oral cleaning, most caregivers use foam swabs with various antiseptic solutions to clean and moisten a patient's mouth. Oral suctioning is commonly performed by inserting a rigid plastic tube, often called a Yankauer suction, into a patient's mouth and throat to suction out saliva and mucus. The purpose of oral cleaning and oral suctioning is to remove bacteria that builds up in the mouth of patients who are unable to perform oral care, such as brushing their teeth. Various studies have shown that the buildup of bacteria in patients who are unable to perform oral care increases their risk of the nosocomial pneumonias, hospital acquired pneumonia (“HAP”) and ventilator associated pneumonia (“VAP”), due to the aspiration of saliva and secretions with high levels of bacteria.
Tracheal suctioning is commonly performed to suction out secretions when a patient is too weak to cough up secretions on their own. Tracheal suctioning may be performed via either nasotracheal suctioning or orotracheal suctioning. In either case, a tracheal suction catheter is used, which typically is a soft, pliable plastic or rubber tube. In the case of nasotracheal suctioning, the tracheal suction catheter is inserted into the naris and continues down the trachea. Once the tracheal suction catheter reaches the trachea, the unwanted secretions are suctioned out. The nasotracheal suctioning method can cause trauma and bleeding to the nasal area. In addition, the suction catheter also has a tendency to coil in the back of the throat and may trigger the patient's gag reflex.
Typically, orotracheal suctioning is attempted in patients with increased coagulation times, nasal fractures, or deviated septums, or if coiling continues to occur in the nasotracheal approach. To perform orotracheal suctioning, the tracheal suction catheter is inserted into the mouth and continues down the trachea. Once the tracheal suction catheter reaches the trachea, the unwanted secretions are suctioned out. Similar to the nasotracheal suctioning method, the suction catheter has a tendency to coil in the back of the throat and may trigger the patient's gag reflex.
Patients are usually in an altered mental state from sedation, confusion, or being frightened and sometimes do not cooperate for oral cleaning, oral suctioning, and tracheal suctioning. Patients sometimes bite down on the cleaning and suctioning instruments, which can stop the oral cleaning, oral suctioning, and tracheal suctioning processes, and sometimes break a piece of the instrument off in the patient's mouth or even bite caregivers' fingers. Other problems that exist include instrument insertion trauma to the nose or mouth and the spread of bacteria from the mouth to the lungs during tracheal suctioning.
Nasogastric tubes and orogastric tubes are commonly used in the course of health-care, most frequently in the preparation before, during, and after surgery, for tube feedings, and in healthcare patients with stomach decompression or other stomach and bowel issues. Typically, these nasogastric/orogastric tubes are formed from resilient plastic material such as polyurethane, polyethylene, or silicone polymer. In addition, these tubes may be manufactured from surgical steel. The nasogastric and orogastric tubes typically have a proximal end, a distal end, and a central lumen or passageway. Further details about such tubes can be found in U.S. Pat. Nos. 4,778,448 and 4,634,425, the disclosures of which are incorporated herein by reference.
Nasogastric tubes and orogastric tubes are either inserted in the mouth or nose, down the throat, and into the stomach. The nasogastric and orogastric tubes have been a problem for patients and clinicians for some time. When a nasogastric tube is inserted into the patient's nose, sometimes the tube coils in the back of the throat and may trigger the patient's gag reflex. Similar to the problems experienced with the oral cleaning, oral suctioning, and tracheal suctioning, patients sometimes bite down on the orogastric tubes, which can stop the process, and sometimes break a piece of the tube off in the patient's mouth or even bite caregivers' fingers.